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Autoimmune hepatitis affects the liver. Autoimmune hepatitis is a disease in which the bodys immune system attacks liver cells. This immune response causes inflammation of the liver, also called hepatitis. Researchers think a genetic factor may make some people more susceptible to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are female. The disease is usually quite serious and, if not treated, gets worse over time. Autoimmune hepatitis is typically chronic, meaning it can last for years, and can lead to cirrhosis scarring and hardeningof the liver. Eventually, liver failure can result. Autoimmune hepatitis is classified as type 1 or type 2. Type 1 is the most common form in North America. It can occur at any age but most often starts in adolescence or young adulthood. About half of those with type 1 have other autoimmune disorders, such as
type 1 diabetes proliferative glomerulonephritis, an inflammation of blood vessels in the kidneys thyroiditis, an inflammation of the thyroid gland Graves disease, the leading cause of overactive thyroid Sjgrens syndrome, a syndrome that causes dry eyes and mouth autoimmune anemia
Type 2 autoimmune hepatitis is less common, typically affecting girls aged 2 to 14, although adults can have it too.
an enlarged liver jaundice itching skin rashes joint pain abdominal discomfort spider angiomas, or abnormal blood vessels, on the skin nausea vomiting loss of appetite dark urine pale or gray-colored stools
People in advanced stages of the disease are more likely to have symptoms related to chronic liver disease, such as fluid in the abdomenalso called ascitesand mental confusion. Women may stop having menstrual periods. Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral hepatitis or hepatitis caused by a drugfor example, certain antibioticshave the same symptoms as autoimmune hepatitis, tests may be needed for an exact diagnosis. Doctors should also review and rule out all medicines a patient is taking before diagnosing autoimmune hepatitis.
Blood tests. A routine blood test for liver enzymes can help reveal a pattern typical of hepatitis, but further tests, especially for autoantibodies, are needed to diagnose autoimmune hepatitis. Antibodies are proteins made by the immune system to fight off bacteria and viruses. Autoantibodies attack the bodys cells. In autoimmune hepatitis, the immune system makes one or more types of autoantibodies. The most common are antinuclear antibodies (ANA), smooth muscle antibodies (SMA), and antibodies to liver and kidney microsomes (antiLKM). People with type 1 have ANA, SMA, or both, and people with type 2 have anti-LKM. Blood tests also help distinguish autoimmune hepatitis from other diseases that resemble it, such as viral hepatitis B or C or a metabolic disease such as Wilson disease.
Liver biopsy. A tiny sample of liver tissue, examined with a microscope, can help doctors accurately diagnose autoimmune hepatitis and tell how serious it is. This procedure is done in a hospital or outpatient surgical facility.
Some people with mild forms of the disease may not need to take medication. Doctors assess each patient individually to determine whether those with mild autoimmune hepatitis should undergo treatment.
weight gain anxiety and confusion thinning of the bones, a condition called osteoporosis thinning of the hair and skin diabetes high blood pressure cataracts glaucoma
Azathioprine can lower white blood cell counts and sometimes causes nausea and poor appetite. Rare side effects are allergic reaction, liver damage, and pancreatitis, which is an inflammation of the pancreas gland with severe stomach pain.
Points to Remember
Autoimmune hepatitis is a long-term disease in which the bodys immune system attacks liver cells. The disease is diagnosed using various blood tests and a liver biopsy. With proper treatment, autoimmune hepatitis can usually be controlled. The main treatment is medicine that suppresses the bodys overactive immune system.
doctors understand what triggers autoimmune hepatitis in some people. Research on different steroids, alternatives to steroids, and other immunosuppressants will eventually lead to more effective treatments.